High-altitude pulmonary edema is initially caused by an increase in capillary pressure

Détails

ID Serval
serval:BIB_F9292F20A7DE
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
High-altitude pulmonary edema is initially caused by an increase in capillary pressure
Périodique
Circulation
Auteur⸱e⸱s
Maggiorini  M., Melot  C., Pierre  S., Pfeiffer  F., Greve  I., Sartori  C., Lepori  M., Hauser  M., Scherrer  U., Naeije  R.
ISSN
0009-7322 (Print)
Statut éditorial
Publié
Date de publication
2001
Volume
103
Numéro
16
Pages
2078-2083
Notes
DA - 20020919
LA - eng
PT - Clinical Trial
PT - Controlled Clinical Trial
PT - Journal Article
PT - Research Support, Non-U.S. Gov't
RN - 0 (Gallium Radioisotopes)
RN - 0 (Organometallic Compounds)
RN - 0 (gallium-transferrin complex)
RN - 11096-37-0 (Transferrin)
SB - AIM
SB - IM
Résumé
BACKGROUND: High-altitude pulmonary edema (HAPE) is characterized by severe pulmonary hypertension and bronchoalveolar lavage fluid changes indicative of inflammation. It is not known, however, whether the primary event is an increase in pressure or an increase in permeability of the pulmonary capillaries. METHODS AND RESULTS: We studied pulmonary hemodynamics, including capillary pressure determined by the occlusion method, and capillary permeability evaluated by the pulmonary transvascular escape of 67Ga-labeled transferrin, in 16 subjects with a previous HAPE and in 14 control subjects, first at low altitude (490 m) and then within the first 48 hours of ascent to a high-altitude laboratory (4559 m). The HAPE-susceptible subjects, compared with the control subjects, had an enhanced pulmonary vasoreactivity to inspiratory hypoxia at low altitude and higher mean pulmonary artery pressures (37 +/- 2 versus 26 +/- 1 mmHg, P<0.001) and pulmonary capillary pressures (19 +/- 1 versus 13 +/- 1 mmHg, P < 0.001) at high altitude. Nine of the susceptible subjects developed HAPE. All of them had a pulmonary capillary pressure >19 mm Hg (range 20 to 26 mmHg), whereas all 7 susceptible subjects without HAPE had a pulmonary capillary pressure < 19 mm Hg (range 14 to 18 mm Hg). The pulmonary transcapillary escape of radiolabeled transferrin increased slightly from low to high altitude in the HAPE-susceptible subjects but remained within the limits of normal and did not differ significantly from the control subjects. CONCLUSIONS: HAPE is initially caused by an increase in pulmonary capillary pressure
Mots-clé
Adult/Altitude/Anoxia/Arteries/blood/Blood Gas Analysis/blood supply/Capillaries/Capillary Permeability/complications/diagnosis/diagnostic use/etiology/Female/Gallium Radioisotopes/Heart Catheterization/Hemodynamics/Humans/Hypertension/Hypertension,Pulmonary/Lung/Male/Middle Aged/Organometallic Compounds/physiopathology/Pulmonary Artery/Pulmonary Circulation/Pulmonary Edema/Pulmonary Wedge Pressure/radiography/Radiography,Thoracic/Reference Values/Switzerland/Transferrin
Pubmed
Web of science
Création de la notice
22/02/2008 15:02
Dernière modification de la notice
20/08/2019 16:25
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